TY  - JOUR
PY  - 2010//
TI  - Clinical features associated with poor pharmacologic adherence in bipolar disorder: results from the STEP-BD study
JO  - Journal of clinical psychiatry
A1  - Perlis, Roy H.
A1  - Ostacher, Michael J.
A1  - Miklowitz, David J.
A1  - Hay, Aleena C.
A1  - Nierenberg, Andrew A.
A1  - Thase, Michael E.
A1  - Sachs, Gary S.
SP  - 296
EP  - 303
VL  - 71
IS  - 3
N2  - BACKGROUND: Poor medication adherence is common among bipolar patients. METHOD: We examined prospective data from 2 cohorts of individuals from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1999-2005) with bipolar disorder. Clinical and sociodemographic features associated with missing at least 25% of doses of at least 1 medication were assessed using logistic regression, and a risk stratification model was developed and validated. RESULTS: Of 3,640 subjects with 48,287 follow-up visits, 871 (24%) reported nonadherence on 20% or more study visits. Clinical features significantly associated (P < .05) with poor adherence included rapid cycling, suicide attempts, earlier onset of illness, and current anxiety or alcohol use disorder. Nonadherence during the first 3 months of follow-up was associated with less improvement in functioning at 12-month follow-up (P < .03). A risk stratification model using clinical predictors accurately classified 80.6% of visits in an independent validation cohort. CONCLUSION: Risk for poor medication adherence can be estimated and may be useful in targeting interventions.<p />  <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/10.4088/JCP.09m05514yel
ID  - ref1
ER  -